Harvard Study: Police Killings A Major Public Health Concern, But Underreported

According to a new Harvard study, police violence kills more U.S. citizens, annually, than the flu and pneumonia combined. So why aren't law-enforcement-related deaths being counted, tracked, and reported, like any other form of mortality affecting the public health?

Alarmingly, the report revealed that, at present, there is no reliable public health data on the number of police killings that occur because of long-standing resistance by police departments to make these data public.

The report explained that, ironically, we only have a sense of how many citizens were killed in the U.S. by police in 2015 because of "The Counted," a United Kingdom-based website launched on June 1, 2015, by the newspaper The Guardian. According to the report, "the website quickly revealed that by June 9, 2015, over 500 people in the US had been killed by the police since January 1, 2015, twice what would be expected based on estimates from the US Federal Bureau of Intelligence (FBI)." At the time of the writing of this article [Dec. 29th, 2015], 1126 U.S. citizens have been killed due to police violence in 2015.

When compared to publicly available U.S. statistics on other common causes of death, the scale at which the endemic problem of police violence occurs, and the extent to which it affects the public well-being, comes into clearer view:

It is startling that we, in the US, must rely on a UK newspaper for systematic timely counts of the number of persons killed by the police. After all, we have a world-class public health system that reports, nationally, in real-time, on numerous notifiable diseases and also on deaths occurring in 122 cities with populations >100,000 [4]. As of September 19, 2015, the cumulative 2015 total of 842 US persons killed by the police [1] notably exceeded the corresponding totals reported for the 122 cities' 442 deaths under age 25 (all causes) and also 585 deaths (all ages) due to pneumonia and influenza, and likewise exceeded the national totals for several diseases of considerable concern: measles (188 cases), malaria (786 cases), and mumps (436 cases), and was on par with the national number of cases of Hepatitis A (890 cases) [4]. Just as epidemic outbreaks can threaten the public's health, so too can police violence and impunity imperil communities' social and economic well-being, especially if civil unrest ensues [1,3,5–8]."

The report makes the compelling argument that law-enforcement-related deaths are not just a criminal justice concern, but a public health concern because they involve mortality and affect the well-being of the families and communities of the deceased.

As a corrective measure, the report suggested that these deaths should be treated as a notifiable condition, "which would allow public health departments to report these data in real-time, at the local as well as national level, thereby providing data needed to understand and prevent the problem."

The report identified three problems presently interfering with the accuracy of publicly available US national mortality data:

(1) they likely provide a conservative estimate (due to underreporting of police killings) [1,3,10]; (2) they are not available on a real-time basis [9,10]; and (3) they are aggregated to the county level [9,10]. Nor are these gaps filled by the US National Violent Death Reporting System (NVDRS), which presently includes only 32 states, and whose public access data are available only up through 2012 and only at the state level [11].

What would it entail to alter public health policy and to treat all law-enforcement–related deaths as a reportable health condition?

They suggest the following remedial action:

"No act of Congress is needed. No police department need be involved. Public health agencies can do the job. Public health experts, working with the US Council of State and Territorial Epidemiologists (which issues recommendations for notifiable conditions [4]) and with public input, can together create uniform case definitions and surveillance protocols to compile, in one uniform system, both: (a) deaths caused by law-enforcement officials (whether in the public or private sector, e.g., both local police officers and private security guards) and (b) occupational fatalities of law-enforcement officials. In our state of Massachusetts, for example, reportable conditions are governed by state regulations [12], they are allowed to include: "injuries or causes of injuries" pertaining to "assaults or homicides," "strikes by/against another object or person," "traumatic brain injuries," and "weapons" ([12], p. 23) (Box 1), and triggers for investigating reportable conditions can include not only health records but also media reports [12], such as The Counted [1]. Although not yet used in Massachusetts to report law-enforcement–related deaths, the enabling regulations exist.

Hence our proposal that law-enforcement–related deaths be a notifiable condition, reported in real time by medical and public health professionals. The harms to individuals and to the public's health merit this monitoring. To our knowledge, this proposed course of action has not previously been suggested. The resulting data could inform advocacy within and across US states to reduce law-enforcement–related mortality and also set precedent for the more complex and costly task of monitoring law-enforcement–related injuries."

Until public law enforcement and health agencies reform their reporting, tracking, and accountability systems, sites like "The Counted" will increasingly be used by the public as authoritative sources for relevant data on the topic.

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